Perceptions of Mesh Use for Pelvic Floor Surgery in Latinas: Face Validity of a Spanish Questionnaire

Abstract

Objective The aim of the study was to validate a Spanish-translated survey assessing patients’ perceptions of mesh use in pelvic floor surgery. Methods An English-language survey evaluating perceptions of mesh use underwent a process of Spanish translation and validation, using a forward-backward translation validation protocol. Self-identified bilingual Latinas with symptoms of pelvic floor disorders were recruited to participate in cognitive interviews after completing the survey in English and Spanish. κ coefficient and Cronbach α were calculated for measurement of reliability and internal consistency in responses. A P value of 0.05 was considered statistically significant. Results A total of 30 women were randomized to complete the initial survey in either English or Spanish. Demographics for the 2 cohorts were similar. For the Spanish-translated survey overall, 86% described the questions as “somewhat easy” or “very easy” to understand, and 93% reported that it was “clear” or “very clear” that the survey aimed to investigate their thoughts regarding mesh use. Approximately 63% of the participants expressed confusion over the use of the Spanish medical term “cabestrillo,” translated for “sling.” There were no significant differences in the responses on cognitive interview between the 2 groups. Overall, the responses between English and Spanish versions of the survey demonstrated good reliability and internal consistency. Conclusions This study demonstrated face validity of a Spanish-translated survey assessing perceptions of mesh use in pelvic surgery in a Latina population. Participants’ feedback was crucial to optimizing the quality of the survey for future studies that will evaluate Spanish-speaking patients’ views of mesh implants in pelvic reconstructive surgery.

Aversion to Mesh Use in Pelvic Floor Surgery in a Latina Population at the U.S.-Mexico Border

“…A significant strength of the current study is the use of a survey translated and validated in Spanish to help assess perceptions of mesh in a predominantly Spanish-speaking community. 11,22 In addition, patient responses on surveys were combined with a chart review of patient symptoms to correlate with factors influencing the likelihood of avoiding mesh surgery. Although these results are not generalizable to the urogynecology population at large, they provide insight into the growing Spanish-speaking populations along the U.S.-Mexico border.…”

“…Once consent was provided, participants completed a survey to evaluate perceptions of mesh use in pelvic floor surgery. 11,22 Surveys were available in English and Spanish and administered to each participant in the language of participant preference. Our group previously published the face validity of the Spanish version.…”

“…Our group previously published the face validity of the Spanish version. 22 In addition, participants completed validated questionnaires, including the Pelvic Floor Distress Inventory Short Form (PFDI-20) and Pelvic Floor Impact Questionnaire Short Form (PFIQ-7) to assess the presence and severity of pelvic floor disorder symptoms, as well as the Short Acculturation Scale for Hispanics (SASH) to assess participants' degree of acculturation. [23][24][25][26] Acculturation can be defined as the manner by which persons born in a foreign country assume the attitudes, values, customs, beliefs, and behavior of another culture.…”

“…[18][19][20][21] The authors previously validated a Spanish-translated survey that assesses patients' perceptions of mesh use in pelvic floor surgery, using a translationback-translation procedure with participant cognitive interviews. 22 This tool can be used in identifying thoughts on mesh among Latinas and the potential impact on the acceptance of surgical treatments in this population. For the current study, the hypothesis was that Latinas may be less willing to accept mesh surgery based on information they had before their office visits.…”

“…Language barriers may be compounded by low health literacy rates and a lack of fundamental knowledge about anatomy and health, which burdens Spanish-speaking patients seeking health care 18–21 . The authors previously validated a Spanish-translated survey that assesses patients' perceptions of mesh use in pelvic floor surgery, using a translation–back-translation procedure with participant cognitive interviews 22 . This tool can be used in identifying thoughts on mesh among Latinas and the potential impact on the acceptance of surgical treatments in this population.…”